Torsten B Jacobsen1. 1. UEMS Section and European Board of Psychiatry, London, UK. tbj@dadlnet.dk
Abstract
PURPOSE OF REVIEW: Involuntary treatment is burdened by the lack of evidence. One of the challenges is the difference in practice across borders in Europe. While reviewing the current literature, a proposal of monitoring guidelines is discussed. RECENT FINDINGS: The field is characterized by a small number of dedicated researchers. A study of violence in first-episode psychosis shows that differences in criteria for involuntary admission lead to different prognosis for the patients. The most recent contributions from the cross-national EUNOMIA study point to great variation across countries, regarding frequencies of involuntary admission as well as outcome. The EUNOMIA study provides suggestions for good quality in involuntary admission. A Cochrane review has examined the evidence of involuntary community treatment compared with standard treatment. The effectiveness of involuntary community treatment is limited. The review concludes that the benefits for a small number of patients are outweighed by the high numbers needed to treat in terms of avoided re-admission. SUMMARY: Despite pioneering work, involuntary treatment is still caught up in tradition. There is a lack of standard and proof of effectiveness. A proposal of monitoring guidelines for involuntary measures is a first step to improve the situation.
PURPOSE OF REVIEW: Involuntary treatment is burdened by the lack of evidence. One of the challenges is the difference in practice across borders in Europe. While reviewing the current literature, a proposal of monitoring guidelines is discussed. RECENT FINDINGS: The field is characterized by a small number of dedicated researchers. A study of violence in first-episode psychosis shows that differences in criteria for involuntary admission lead to different prognosis for the patients. The most recent contributions from the cross-national EUNOMIA study point to great variation across countries, regarding frequencies of involuntary admission as well as outcome. The EUNOMIA study provides suggestions for good quality in involuntary admission. A Cochrane review has examined the evidence of involuntary community treatment compared with standard treatment. The effectiveness of involuntary community treatment is limited. The review concludes that the benefits for a small number of patients are outweighed by the high numbers needed to treat in terms of avoided re-admission. SUMMARY: Despite pioneering work, involuntary treatment is still caught up in tradition. There is a lack of standard and proof of effectiveness. A proposal of monitoring guidelines for involuntary measures is a first step to improve the situation.
Authors: Johanna Baumgardt; Dorothea Jäckel; Heike Helber-Böhlen; Nicole Stiehm; Karin Morgenstern; Andre Voigt; Enrico Schöppe; Ann-Kathrin Mc Cutcheon; Edwin Emilio Velasquez Lecca; Michael Löhr; Michael Schulz; Andreas Bechdolf; Stefan Weinmann Journal: Front Psychiatry Date: 2019-05-24 Impact factor: 4.157
Authors: D Wasserman; G Apter; C Baeken; S Bailey; J Balazs; C Bec; P Bienkowski; J Bobes; M F Bravo Ortiz; H Brunn; Ö Bôke; N Camilleri; B Carpiniello; J Chihai; E Chkonia; P Courtet; D Cozman; M David; G Dom; A Esanu; P Falkai; W Flannery; K Gasparyan; G Gerlinger; P Gorwood; O Gudmundsson; C Hanon; A Heinz; M J Heitor Dos Santos; A Hedlund; F Ismayilov; N Ismayilov; E T Isometsä; L Izakova; A Kleinberg; T Kurimay; S Klæbo Reitan; D Lecic-Tosevski; A Lehmets; N Lindberg; K A Lundblad; G Lynch; C Maddock; U F Malt; L Martin; I Martynikhin; N O Maruta; F Matthys; R Mazaliauskiene; G Mihajlovic; A Mihaljevic Peles; V Miklavic; P Mohr; M Munarriz Ferrandis; M Musalek; N Neznanov; G Ostorharics-Horvath; I Pajević; A Popova; P Pregelj; E Prinsen; C Rados; A Roig; M Rojnic Kuzman; J Samochowiec; N Sartorius; Y Savenko; O Skugarevsky; E Slodecki; A Soghoyan; D S Stone; R Taylor-East; E Terauds; C Tsopelas; C Tudose; S Tyano; P Vallon; R J Van der Gaag; P Varandas; L Vavrusova; P Voloshyn; J Wancata; J Wise; Z Zemishlany; F Öncü; S Vahip Journal: Eur Psychiatry Date: 2020-08-24 Impact factor: 5.361